Writing with Scissors is the blog site of Howard Rodenberg, MD MPH, former Kansas State Health Director and columnist for the Journal of Emergency Medical Services (JEMS). He is a father, emergency physician, and slightly-past-fifty curmudgeon with great hair for his age. The "scissors" in question refer to those used by editors to weed out all things opinonated, controversial, or politically inappropriate...translated as "anything funny."

a new day
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2016 is literally around the corner, leaving me with 18 months to
retirement. Its with a mixture of trepidation, expectation and hope that I
turn the page....

1 year ago

Thursday, June 9, 2011

Rich 'Ol Me

I’ve heard that President Obama wants to raise taxes on the wealthy. Much to my surprise, it turns out I’m one of them. It’s not that I didn’t know my income. Every month when the bills are due I do the multiplication, (dollars per hour) x (hours per shift) x (shifts per month). Nonetheless, I had no idea I was wealthy. When I think of the wealthy, I think of folks playing golf and sipping cocktails at the club, living off investments and inheritances. I think of CEO’s and shrewd financiers; I think of Wall Street folks counting their cash, looking down on us from their penthouse views. I think of Robber Barons and Paris Hiltons, of reality stars, Bridezillas, and anyone named Kardashian.

When I think of the wealthy, I don’t think of a guy who’s pushing 50 and still working in an ER, mixing up his days and nights, spending more time in a Hampton Inn and eating instant oatmeal that in his own bed sipping a cup of tea served by a white-gloved valet. (The reality, of course, is that I make my own cup of tea, carry it to the bedroom, and then fight off the cat who just wants to share.) I don’t think of a guy who’s upside down on three mortgages and doesn’t want to default because of some antiquated sense of obligation (thank you, Wall Street…and you enjoy those record profits). I don’t think of someone living paycheck to paycheck with back taxes (from retirement accounts cashed in when the market first crashed…thanks again, Goldman Sachs); with child support and student loans still not paid off over twenty years after med school. I would be perfectly happy to be considered “wealthy” if I actually got paid for everything I do, but given that in some surveys half or more of all ED care is actually “given away” and not reimbursed, I am not so fortunate. And we won’t even get into the questions of liability I face for my actions, problems unknown to attorneys, investment bankers, or policymakers.

As a former professional bureaucrat, I really don’t have a problem paying taxes. What I object to is being labeled as “wealthy” and taxed at a higher rate simply to satisfy someone’s idea of class warfare. There is a clear difference between the “wealthy” who bust their butts to earn their keep, and those for whom the money simply rolls in. For the latter, a higher tax rate is a mere inconvenience; for the former, it’s a form of punishment, a clear message from the government about the value…or lack thereof…of hard work and effort. And the tax code is so convoluted that any sense of fairness is gone…it’s pretty clear that the “wealthy,” at least as I think of them, also have the resources to avoid the biggest tax bites.

But as my father told me some years ago, it’s not enough to have an opinion; you have to know why you think that way and what you would do about it. So here’s the Rodenberg Plan:

First, individuals are taxed at a consistent, graduated rate. The current numbers we have, with a top tax rate of 25%, works for me. Medicare, Social Security, and Medicaid taxes continue as a fixed percentage of income to a maximum rate. There are a minimal number of deductions, such that the tax code can be summarized in an hour-long Power Point presentation. Deductions can apply for dependents, mortgages, taxes paid to states, and student loans. There should be new deductions for those who pay child support and alimony; the recipients of these funds should have to pay taxes upon them as income. Other than that, your tax is your tax. Individual sate income taxes should follow a similar model.

(For the record, I think that if a piece of legislation cannot be fully explained to a lay audience in a sixty minute Power Point presentation…including cartoons and jokes…the legislation is too complex and needs to be thrown out.)

Second, corporate taxes should be based on a graduated but fixed percentage model as well. Tax credits or deductions could be granted for investments in infrastructure, employer support of employee benefits, or the creation of actual, filled jobs. Tax shelters in the form of offshore accounts and domestic loopholes need to be closed.

Finally, entitlement programs need to be means-tested. If I’m fortunate enough to live well in retirement, I’m willing to forego my Social Security payment as the dues I pay to have lived in an affluent society. I have a similar feeling about Medicare benefits; if I can afford my own insurance, I ought to do so rather than taking more money from the public purse. Again, it’s my personal sacrifice for the benefit of having been successful in life. And I believe that within Medicaid, services must be limited on the basis of medical necessity and cost-benefit ratio.

I think this plan has something for everyone. Democrats will like the emphasis or corporate taxation, and making the “wealthy” pay their own way rather than using public funds for a golf-centered dotage. Republicans will appreciate lower individual tax rates and a simplified tax code. Of course, special interest on both the left and the right will find reasons to trash these ideas, just as they will any ideas the real politicians may choose to propose. (This is assuming that the politicians don’t find reasons to trash each other’s idea first.)

Meanwhile, I’ll have to start learning to be wealthy. Maybe next time I drive through Kansas, I’ll rent the Full-Size Car rather than the Compact. And if only I could get the folks at the Hampton Inn to have room service…